Haematologic Parameters In Acute Promyelocytic Leukemia Patients Treated With ALL Trans- Retinoic acid

Background: Acute Promyelocytic Leukemia (APL) is commonly associated with disseminated intravascular coagulation (DIC) and early correction of coagulopathy is of vital importance. All Trans-Retinoic Acid (ATRA) is considered to be the drug of choice in the treatment of APL.  Objective: The work was...

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Main Authors: Alaa G. Hussein, Mohammed Sh. Ali, Maha Sh. Hassan, Saad Sh. Mansoor, Ali M. AL- Ameri, Raad J. Muhsin
Format: Article
Language:English
Published: College of Medicine University of Baghdad 2007-04-01
Series:مجلة كلية الطب
Subjects:
Online Access:http://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/1413
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author Alaa G. Hussein
Mohammed Sh. Ali
Maha Sh. Hassan
Saad Sh. Mansoor
Ali M. AL- Ameri
Raad J. Muhsin
author_facet Alaa G. Hussein
Mohammed Sh. Ali
Maha Sh. Hassan
Saad Sh. Mansoor
Ali M. AL- Ameri
Raad J. Muhsin
author_sort Alaa G. Hussein
collection DOAJ
description Background: Acute Promyelocytic Leukemia (APL) is commonly associated with disseminated intravascular coagulation (DIC) and early correction of coagulopathy is of vital importance. All Trans-Retinoic Acid (ATRA) is considered to be the drug of choice in the treatment of APL.  Objective: The work was conducted to 1- Identify patients with APL who show laboratory evidence of DIC. 2- Study the serial changes in haemostatic parameters in APL patients treated with ATRA and to compare their results with those treated with conventional chemotherapy without ATRA. Subjective and methods: In this prospective study (from October 2003 to October 2005), 44 newly diagnosed, untreated APL patients were included. ATRA plus chemotherapy – treated patients were 24 while 17 patients were treated with chemotherapy other than ATRA. For each patient, a full clinical evaluation was done and hematological investigations were accomplished at time of diagnosis and repeated on day 3 and 7 of therapy. Diagnosis of DIC was based on finding a positive D- dimer test with hypofibrinogenaemia with or without pathologically prolonged (PT and/or APTT). Results: In 44 newly diagnosed, untreated APL patients studied, the age range between 6-81 years with a median of 27 years. Male to female ratio was 1.3:1. Before treatment all patients had anemia, thrombocytopenia, and elevated level of D – dimer. DIC was present in all patients at time of diagnosis. All parameters that showed abnormal level at time of diagnosis had returned to normality within one week in ATRA treated group, indicating that DIC has essentially resolved. By contrast, those parameters remained abnormal even on day 7 in the chemotherapy treated group. Indicating that DIC was on going. Conclusion: ATRA therapy in APL patients is associated with rapid improvement of coagulopathy therefore , it is justified to be used from day one of the treatment.
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spelling doaj.art-49ea6f2ea52e4f86989c5d744da99bb92024-01-02T16:44:51ZengCollege of Medicine University of Baghdadمجلة كلية الطب0041-94192410-80572007-04-01491Haematologic Parameters In Acute Promyelocytic Leukemia Patients Treated With ALL Trans- Retinoic acidAlaa G. Hussein0Mohammed Sh. Ali1Maha Sh. Hassan2Saad Sh. Mansoor3Ali M. AL- Ameri4Raad J. Muhsin5College of Medicine/ AL-Nahrain Univirsity.College of Medicine/ Kerbalaa Univirsity.College of Medicine: AL- Nahrain Univirsity.College of Medicine: AL- Nahrain Univirsity.National center of haematology, ALMustansiriya Univirsity.College of Medicine: AL- Nahrein UnivirsityBackground: Acute Promyelocytic Leukemia (APL) is commonly associated with disseminated intravascular coagulation (DIC) and early correction of coagulopathy is of vital importance. All Trans-Retinoic Acid (ATRA) is considered to be the drug of choice in the treatment of APL.  Objective: The work was conducted to 1- Identify patients with APL who show laboratory evidence of DIC. 2- Study the serial changes in haemostatic parameters in APL patients treated with ATRA and to compare their results with those treated with conventional chemotherapy without ATRA. Subjective and methods: In this prospective study (from October 2003 to October 2005), 44 newly diagnosed, untreated APL patients were included. ATRA plus chemotherapy – treated patients were 24 while 17 patients were treated with chemotherapy other than ATRA. For each patient, a full clinical evaluation was done and hematological investigations were accomplished at time of diagnosis and repeated on day 3 and 7 of therapy. Diagnosis of DIC was based on finding a positive D- dimer test with hypofibrinogenaemia with or without pathologically prolonged (PT and/or APTT). Results: In 44 newly diagnosed, untreated APL patients studied, the age range between 6-81 years with a median of 27 years. Male to female ratio was 1.3:1. Before treatment all patients had anemia, thrombocytopenia, and elevated level of D – dimer. DIC was present in all patients at time of diagnosis. All parameters that showed abnormal level at time of diagnosis had returned to normality within one week in ATRA treated group, indicating that DIC has essentially resolved. By contrast, those parameters remained abnormal even on day 7 in the chemotherapy treated group. Indicating that DIC was on going. Conclusion: ATRA therapy in APL patients is associated with rapid improvement of coagulopathy therefore , it is justified to be used from day one of the treatment.http://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/1413Haematologic Parameters
spellingShingle Alaa G. Hussein
Mohammed Sh. Ali
Maha Sh. Hassan
Saad Sh. Mansoor
Ali M. AL- Ameri
Raad J. Muhsin
Haematologic Parameters In Acute Promyelocytic Leukemia Patients Treated With ALL Trans- Retinoic acid
مجلة كلية الطب
Haematologic Parameters
title Haematologic Parameters In Acute Promyelocytic Leukemia Patients Treated With ALL Trans- Retinoic acid
title_full Haematologic Parameters In Acute Promyelocytic Leukemia Patients Treated With ALL Trans- Retinoic acid
title_fullStr Haematologic Parameters In Acute Promyelocytic Leukemia Patients Treated With ALL Trans- Retinoic acid
title_full_unstemmed Haematologic Parameters In Acute Promyelocytic Leukemia Patients Treated With ALL Trans- Retinoic acid
title_short Haematologic Parameters In Acute Promyelocytic Leukemia Patients Treated With ALL Trans- Retinoic acid
title_sort haematologic parameters in acute promyelocytic leukemia patients treated with all trans retinoic acid
topic Haematologic Parameters
url http://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/1413
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